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      <NetIncomeOrLoss>
        <TotalRevenueColumn>613992</TotalRevenueColumn>
        <ExclusionAmount>613992</ExclusionAmount>
      </NetIncomeOrLoss>
      <TotalOtherRevenue>0</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>29831073</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>25747237</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>490580</UnrelatedBusinessRevenue>
        <ExclusionAmount>1036061</ExclusionAmount>
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      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>228028</Total>
        <ProgramServices>114014</ProgramServices>
        <ManagementAndGeneral>57007</ManagementAndGeneral>
        <Fundraising>57007</Fundraising>
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      <CompDisqualPersons>
        <Total>0</Total>
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        <Total>13937928</Total>
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        <ManagementAndGeneral>2114798</ManagementAndGeneral>
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      <PensionPlanContributions>
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      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>1368512</Total>
        <ProgramServices>1120971</ProgramServices>
        <ManagementAndGeneral>247541</ManagementAndGeneral>
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      <PayrollTaxes>
        <Total>1469804</Total>
        <ProgramServices>1131749</ProgramServices>
        <ManagementAndGeneral>338055</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>27605</Total>
        <ProgramServices>563</ProgramServices>
        <ManagementAndGeneral>27042</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>0</Total>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
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      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
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        <ManagementAndGeneral>62841</ManagementAndGeneral>
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      <Advertising>
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      </Advertising>
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        <ProgramServices>73562</ProgramServices>
        <ManagementAndGeneral>183741</ManagementAndGeneral>
        <Fundraising>9087</Fundraising>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>0</Total>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>644407</Total>
        <ProgramServices>520478</ProgramServices>
        <ManagementAndGeneral>105040</ManagementAndGeneral>
        <Fundraising>18889</Fundraising>
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      <Travel>
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        <ProgramServices>33582</ProgramServices>
        <ManagementAndGeneral>7145</ManagementAndGeneral>
        <Fundraising>558</Fundraising>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>78530</Total>
        <ProgramServices>52919</ProgramServices>
        <ManagementAndGeneral>13460</ManagementAndGeneral>
        <Fundraising>12151</Fundraising>
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      <Interest>
        <Total>350252</Total>
        <ProgramServices>216456</ProgramServices>
        <ManagementAndGeneral>65497</ManagementAndGeneral>
        <Fundraising>68299</Fundraising>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>551047</Total>
        <ProgramServices>344051</ProgramServices>
        <ManagementAndGeneral>201031</ManagementAndGeneral>
        <Fundraising>5965</Fundraising>
      </DepreciationDepletion>
      <Insurance>
        <Total>0</Total>
      </Insurance>
      <OtherExpenses>
        <Description>Printing and Publications</Description>
        <Total>149527</Total>
        <ProgramServices>119972</ProgramServices>
        <ManagementAndGeneral>343</ManagementAndGeneral>
        <Fundraising>29212</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>PATIENT CARE &amp; PROGRAM EXP.</Description>
        <Total>4913507</Total>
        <ProgramServices>4641199</ProgramServices>
        <ManagementAndGeneral>203110</ManagementAndGeneral>
        <Fundraising>69198</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>INSURANCE</Description>
        <Total>137261</Total>
        <ProgramServices>84827</ProgramServices>
        <ManagementAndGeneral>25668</ManagementAndGeneral>
        <Fundraising>26766</Fundraising>
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      <OtherExpenses>
        <Description>CONSULTING AND OUTSIDE SERVICE</Description>
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        <ProgramServices>884626</ProgramServices>
        <ManagementAndGeneral>55715</ManagementAndGeneral>
        <Fundraising>7500</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>COMPUTER SUPPORT &amp; ACCESS FEES</Description>
        <Total>189164</Total>
        <ProgramServices>132415</ProgramServices>
        <ManagementAndGeneral>47291</ManagementAndGeneral>
        <Fundraising>9458</Fundraising>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>259125</Total>
        <ProgramServices>99526</ProgramServices>
        <ManagementAndGeneral>124359</ManagementAndGeneral>
        <Fundraising>35240</Fundraising>
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      <TotalFunctionalExpenses>
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      <ReceivablesFromOfficersEtc>
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      <OtherNotesLoansReceivableNet>
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      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
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      <PrepaidExpensesDeferredCharges>
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      <LandBuildingsEquipmentBasis>14574767</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>3168742</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
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      <InvestmentsPubTradedSecurities>
        <BOY>1351998</BOY>
        <EOY>1410808</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <EOY>0</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
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      </InvestmentsProgramRelated>
      <IntangibleAssets>
        <EOY>0</EOY>
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      <OtherAssetsTotal>
        <BOY>2007746</BOY>
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      <TotalAssets>
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      <AccountsPayableAccruedExpenses>
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      <DeferredRevenue>
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        <EOY>11551</EOY>
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      <MortNotesPyblSecuredInvestProp>
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        <EOY>4386570</EOY>
      </MortNotesPyblSecuredInvestProp>
      <OtherLiabilities>
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        <EOY>1227805</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>8489227</BOY>
        <EOY>6418307</EOY>
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      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
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        <EOY>15771725</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>966898</BOY>
        <EOY>1149850</EOY>
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      <PermanentlyRestrictedNetAssets>
        <BOY>457024</BOY>
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      <TotalNetAssetsFundBalances>
        <BOY>13201361</BOY>
        <EOY>17378599</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>21690588</BOY>
        <EOY>23796906</EOY>
      </TotalLiabNetAssetsFundBalances>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>false</FederalGrantAuditPerformed>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="09000047" softwareVersion="2009v1.7">
      <PubliclySupportedOrg509a2>X</PubliclySupportedOrg509a2>
      <GiftsGrantsContribReceived509>
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        <CurrentTaxYearMinus2Years>5757972</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>3101704</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>3183067</CurrentTaxYear>
        <Total>18909899</Total>
      </GiftsGrantsContribReceived509>
      <GrossReceiptsFromAdmissions>
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        <CurrentTaxYearMinus3Years>18691487</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>23194353</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>24274930</CurrentTaxYearMinus1Year>
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        <Total>109217739</Total>
      </GrossReceiptsFromAdmissions>
      <GrossReceiptsFromNonUBI>
        <Total>0</Total>
      </GrossReceiptsFromNonUBI>
      <TaxRevLeviedForOrgBenefit509>
        <Total>0</Total>
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      <ValueOfSvcsFcltsFurnishdByGovt>
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      </ValueOfSvcsFcltsFurnishdByGovt>
      <Total509>
        <CurrentTaxYearMinus4Years>20203148</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>22196238</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>28952325</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>27376634</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>29399293</CurrentTaxYear>
        <Total>128127638</Total>
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      <AmtsRecdFromDisqualPersons>
        <Total>0</Total>
      </AmtsRecdFromDisqualPersons>
      <AmtsFromSubstContributors>
        <Total>0</Total>
      </AmtsFromSubstContributors>
      <PublicSupportTotal509>128127638</PublicSupportTotal509>
      <GrossInvestmentIncome509>
        <CurrentTaxYearMinus4Years>70593</CurrentTaxYearMinus4Years>
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      <Post1975UBTI>
        <Total>0</Total>
      </Post1975UBTI>
      <InvestmentIncomeAndUBTI>
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        <CurrentTaxYear>45839</CurrentTaxYear>
        <Total>333009</Total>
      </InvestmentIncomeAndUBTI>
      <NetIncomeFromOtherUBI>
        <Total>0</Total>
      </NetIncomeFromOtherUBI>
      <OtherIncome509>
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        <CurrentTaxYearMinus2Years>1168</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>-20237</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>227578</CurrentTaxYear>
        <Total>492317</Total>
      </OtherIncome509>
      <TotalSupportTotal>
        <Total>128952964</Total>
      </TotalSupportTotal>
      <PublicSupportPercentage509>0.99360</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.99400</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00260</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00280</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="09000047" softwareVersion="2009v1.7">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
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    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="09000047" softwareVersion="2009v1.7">
      <Land>
        <OtherCostOrOtherBasis>3587925</OtherCostOrOtherBasis>
        <BookValue>3587925</BookValue>
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      <Buildings>
        <OtherCostOrOtherBasis>9219030</OtherCostOrOtherBasis>
        <Depreciation>1916246</Depreciation>
        <BookValue>7302784</BookValue>
      </Buildings>
      <Equipment>
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        <Depreciation>1252496</Depreciation>
        <BookValue>515316</BookValue>
      </Equipment>
      <TotalOfBookValueLandBuildings>11406025</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>SHORT TERM INVESTMENTS</Description>
        <BookValue>2205622</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>LIFE INCOME GIFTS</Description>
        <BookValue>86959</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>CERTIFICATE OF DEPOSIT</Description>
        <BookValue>147090</BookValue>
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      <OtherAssets>
        <Description>CASH</Description>
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      <TotalBookValueOtherAssets>2439671</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>SECURITY DEPOSITS</Description>
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      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DEFERRED LIABILITY LIFE INCOME GIFT</Description>
        <Amount>17536</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>CAPITAL LEASE OBLIGATION</Description>
        <Amount>70895</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED COMPENSATION</Description>
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      <TotalOfAmounts>1227805</TotalOfAmounts>
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      <ExcessOrDeficitForYear>4208019</ExcessOrDeficitForYear>
      <ExcessOrDeficitPerFS>4208019</ExcessOrDeficitPerFS>
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      <RevenueSubtotal>29831073</RevenueSubtotal>
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      <Form990ScheduleDPartXIV>
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        <ReturnReference>Part XIII, Line 2d: Other expenses and losses per audited F/S</ReturnReference>
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      <Form990ScheduleDPartXIV>
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        <ReturnReference>Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990</ReturnReference>
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      <EventsInformation>
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        <GrossRevenueEvent1>625872</GrossRevenueEvent1>
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        <GrossRevenueTotalEvents>625872</GrossRevenueTotalEvents>
        <OtherDirectExpensesTotalEvents>332217</OtherDirectExpensesTotalEvents>
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    </IRS990ScheduleG>
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      <CompensationCommittee>X</CompensationCommittee>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
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        <BaseCompensationFilingOrg>175500</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>22000</DeferredCompFilingOrg>
        <TotalCompensationFilingOrg>197500</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>87750</CompReportPrior990FilingOrg>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="09000047" softwareVersion="2009v1.7">
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        <Explanation>TAXPAYER REQUIRES ADDITIONAL TIME TO GATHER SUFFICIENT DATA TO FILE A COMPLETE AND ACCURATE RETURN.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>COMPENSATION COMMITTEE OF THE BOARD DETERMINES COMPENSATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>SIGN STATEMENTS ANNUALLY</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>C.E.O., C.F.O. AND FINANCE COMMITTEE REVIEWS BEFORE FILING.</Explanation>
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</Return>